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Self-reported screening improves symptom management for children with cancer
Summary:
New research shows routine symptom screening reduces symptom burden and supports implementing care pathways for improved symptom management.
Regularly asking kids with cancer about their symptoms can make a big difference in how they feel, finds new research led by scientists at The Hospital for Sick Children (SickKids) and the University of Toronto (U of T).
In two separate studies published in JAMA and JAMA Pediatrics, a research team led by Drs. Lillian Sung, Chief Clinical Data Scientist and Lee Dupuis, Associate Senior Scientist at SickKids, found that routine symptom screening can significantly reduce how much young cancer patients are bothered by their symptoms and influence informed decision making for families and caregivers.
“Patient reported data are crucial to improving care overall and also to providing better supportive care that enhances kids' quality of life by focusing on what they really want help with,” says Sung, who is also a Paediatric Oncologist and Senior Scientist in the Child Health Evaluative Sciences program at SickKids and professor at the Institute of Health Policy Management and Evaluation and Department of Paediatrics at U of T.
Screenings tools led to significant decrease in bothersome symptoms
One study, published in JAMA, involved 445 kids aged eight to 18 years from 20 paediatric cancer centres in the U.S. They were divided into two groups: one that used a new symptom screening tool and another that received usual care. During the eight-week study, the kids using the symptom screening tool reported significantly lower symptom burden compared to those receiving usual care.
Speedy symptom resolution
Self-reported symptom scores were measured using a tool called Symptom Screening in Pediatrics Tool (SSPedi, pronounced ‘speedy’), a validated symptom assessment tool previously developed by the study co-leads. Patients were able to complete and track their symptom scores in an interactive and child-friendly web application called Supportive Care Prioritization, Assessment and Recommendations for Kids (SPARK) that lets kids rate how bothered they are by various symptoms, such as feeling sad, worried, or having physical discomforts like nausea or constipation.
“While we are seeing encouraging survival rates for kids diagnosed with cancer, it’s universal that children express severe bother due to treatment they receive,” says first-author Dupuis, who is also a Clinical Pharmacist at SickKids and professor at the Leslie Dan Faculty of Pharmacy at U of T. “The main purpose of symptom screening is to allow children to have a real voice and express the degree to which they are bothered by these symptoms so we can find ways to make their treatment kinder.”
The research team also followed 345 paediatric cancer patients at eight tertiary care centres in Canada, with similarly impressive results published in JAMA Pediatrics.
Self-screening associated with more emergency visits
One unexpected finding was that kids in the screening group had more visits to the emergency department. Researchers believe this might be because parents, being more aware of their child’s symptoms through the screening reports, sought additional medical help.
“An important takeaway from this finding is that we can look at ways to prepare supportive care pathways for parents and children that can empower them to make informed decisions about their own symptoms,” says Dupuis.
Funding for this study was provided by the Canadian Institutes of Health Research and the National Institutes of Health. Early development of SSPedi was supported by the Pediatric Oncology Group of Ontario.
Read the original release.